Institute of Community and Public HealthBirzeit University 1 October 2002
Introduction
For two years to date the Institute of Community and Public Health has operated its teaching and policy oriented research projects in exceptional circumstances, as the beginning of the Second Palestinian Uprising in September 2000 marked the initiation of a new phase in the history of the Palestinian nation. This period required concerted efforts to re-adjust activities to suit the emerging war-like conditions. Previous to this period, the Institute was implementing a variety of teaching, training and research programmes. Those primarily aimed at assisting in the process of rehabilitating and re-constructing the Palestinian health care system in ways that can address people’s health needs with equity and quality, and with the notion of the right to health as a core.
After a month of University closure in October of 2000, Institute faculty and staff began to gradually get back to work, accommodating exceptional circumstances by reaching Birzeit University at times, and by decentralizing operations to homes in Ramallah at others. New projects relevant to emergency conditions were developed, old but relevant ones continued. The gradual deterioration of the situation over time - especially the condition of the road to Birzeit - as well as the frequent shelling and destruction, invasions and occupation, in addition to the increasing number of total curfew days, all led to increasing decentralization efforts. By September of 2002, a little office located in the garage of one of our staff was set up in Ramallah, allowing Institute faculty and staff to continue working despite the by then almost total lack of access to the University campus, and the war conditions that rocked the country into substantial disarray.
Our teaching schemes were particularly affected; closures, siege, the periodic gouging out of roads, and particularly the destruction of the University’s precious fiber-optic internet lines all led to serious impediments to the continuation of the academic process. Faculty and staff were often caught under siege and curfew in areas not accessible to the teaching venue (faculties live in Jerusalem, Bethlehem and Nablus, in addition to Ramallah and Birzeit). Access to the teaching venue was an even more serious impediment to students, as they generally come from the various districts of the West Bank. Gradually they started reaching us for teaching in ways that would have been un-imaginable previously. As the problem of the road to Birzeit remained the single-most important impediment to campus access, teaching at times was resumed in Ramallah in rented halls, at the price of having no access to the Institute Resource Center and Computer laboratory, and compromising the learning process.
The Ramallah-Birzeit Road
The Institute lies at the heart of Birzeit village, approximately 10 kilometers away from the twin city of Ramallah/al-Bireh. It is located at about a 3-kilometer distance from the University’s new campus that is situated on the outskirts of Birzeit town, and is well connected to the New Campus with shared taxi services as well as Internet links.
While periodic obstructions of the road linking Ramallah to Birzeit started as early as the beginning of this current Uprising - with the erection of an Israeli army checkpoint and the consequent denial of access - the Israeli occupation forces began to seriously and systematically obstruct travel on this road in March of 2001. The obstruction included the digging of ditches and erection of barriers, making vehicular travel impossible and pedestrian crossing difficult and dangerous, often by way of alternative dirt paths. At other times, the road would be opened to vehicles and pedestrians for some time during a particular day, and then suddenly totally blocked, leaving cars, faculty, staff and students stranded either in Birzeit or in Ramallah. This situation varied hourly, not daily. On the occasion of the road opening for the whole day, a checkpoint, usually manned by not more than a few soldiers, would delay the passage of everyone for hours or minutes depending on their luck. Many students were delayed for their classes, beaten and humiliated; they were asked to take off their clothes, made to stand on their knees or sit on bare ground for hours under the sun, with hands cuffed. Most were released, but some were even detained and arrested. Other times, tear gas bombs and stun grenades were thrown at pedestrians and cars transporting the students. In one such incident, the University’s Webmaster’s leg was broken as a result of a direct hit by a sound bomb.
Soon, a 15 minute taxi ride was turned into a 2-3 hour dangerous journey. It began by picking up a shared taxi in Ramallah and getting out at a variable distance before the checkpoint, depending on the date of the latest gouging out of the road. One had to then walk through the remains of the gouged out road past the checkpoint, in order to take a shared taxi on the other side to Birzeit. The conditions were bad during the hot summer months, but were considerably worse during the winter months, due to the rain, hail, and sometimes snow, in addition to the mud from the no-longer-paved road.
No reason was ever given for any of these difficulties by the soldiers. They were especially surprising since there were no provocations in that area by either students or faculty. So, we reached the natural conclusion that the Israeli occupying force is intent on intimidating and humiliating the Palestinians, and obstructing higher education. Indeed, it is doing its utmost to deny Palestinians of all ages, beginning with kindergarten and ending with University level studies, the right to education. Given that the Birzeit road is the only access to Ramallah for about 50,000 inhabitants of villages surrounding Birzeit , it was above all children, the elderly, and the disabled from these villages who were in need of emergency assistance, and were forced to go through this road of endurance and humiliation, who suffered most from the blockade.
Several attempts at peacefully protesting the closure of the road by village inhabitants, University faculty, administration, and students, as well as civil society institutions and internationals were made, but were neither successful in attracting the attention of the media, nor in ameliorating the conditions. In fact, the Israeli reactions were always heavy-handed, coming in the now expected response of tear gas, rubber and even live bullet shots directed at marchers. Several people were injured during such occasions. In addition, a first aid volunteer arriving to assist the peaceful protesters was shot at with a rubber-coated metal bullet, which went straight into his eye. Despite every effort to save his eye, including travel abroad, he eventually lost his eyesight completely. What is even more remarkable is that he is back again working as a first aid volunteer in the same area!
Other attempts to accommodate emergency conditions were made by students and staff, with some managing to move their residence to Birzeit village. On the whole, this attempt remained lame, as most teachers could not leave their families behind in difficult and dangerous times. Many students could not move to Birzeit because the costs of such moves were prohibitive, especially in conditions of spiraling poverty and unemployment.
Many of those who did move to Birzeit were cut off from their families and friends for weeks and months at a time, as their loved ones were being subjected to more incursions, destruction and curfew days. By the end of September 2002, the time of writing this report, and after an almost entire month of curfew days in Ramallah, as well as periodic curfews and occupation in Birzeit village, the University undergraduate and postgraduate programmes had not begun operating as scheduled.
Postgraduate Education at the ICPH During the Intifada
The Institute operates two teaching programmes: the Diploma in Primary Health Care and the Masters in Public Health. Attending students are usually older student professionals who enroll at the Institute in a mid-career human resource development scheme. The students are professionals who work either in the health sector or related spheres. About 50% of students are physicians and nurses, and the rest include veterinarians, dentists, pharmacists, laboratory technologists as well as social workers, teachers, psychologists, researchers, statisticians and engineers who work within the broader framework of public health. The majority of students work within the Palestinian Authority structures ( the various ministries, such as the Ministries of Health, Education, Environment, Industry, Food Supply, in addition to governorates and municipalities), or with the myriad local non-governmental health organizations, as well as the United Nation Relief and Work Agency. Although they carry an almost full time study load, their teaching programme is organized in such a way as to allow them to work and study at the same time. Other than the required intensive teaching week that takes place at the beginning of each semester, where classes are held daily for five days from 8 am till 3.30 pm, teaching days are set for Wednesdays and Thursdays of each week, beginning at 8 a.m and theoretically ending at 3.30 pm ( we have had to shorten the teaching day during the past two years by cutting down on break time and increasingly, on contact time).
Coping with Emergency
After the month of University closure in October of 2000, teaching at the Institute resumed, at first effectively, where it appeared that operations at the University were hardly affected by the events taking place in the country. However, increasingly, students were having a hard time reaching the Institute premises mainly because of blockades in their areas.
Initially, soldiers at the check-point separating Ramallah from Birzeit on the Birzeit road would allow travel by car after verifying identity cards and searching cars. Soon, only some cars were allowed through the checkpoint and not others, and this appeared to be completely haphazard, maybe partially dependent on the ability to argue calmly, in English! As the events progressed, cars were allowed in at some times but not others, leaving faculty, staff and student cars stranded in Birzeit or on the road. Eventually, cars were totally denied entry, with the exception of those with special permits like ambulances and medication and food transporters. Students and staff gradually accommodated these constantly changing situations by first traveling by taxi or personal cars (that were left by the side of the road) to the rubble or cemented roadblocks. Then everyone had to walk about 1 kilometer and cross the checkpoint, to catch a taxi on the other side of the checkpoint. Eventually, staff and students started using shared taxis for the interrupted journey after the army began to wreck the cars that were parked close to the checkpoint.
Clearly, these violations of the most basic principles of human rights were not enough. Soon, the road was closed completely, blocking any access to and from the University. Once the total blockade became repetitive and was made permanent by what looked at first like an unimaginable gouging out of the road, destruction of the piped water supply, the phone lines and the Internet connection of the University, we decided to relocate the teaching to Ramallah, as Ramallah remained slightly more accessible than Birzeit. Since that time, the destruction of roads that had been repaired sometimes just days before, became a routine action, something similar to a cat-and-mouse game, with the army gouging out and, on days of curfew lifting, the Palestinians fixing up the damage. At some point, the fixing operations became make-shift, with the young men leveling the mountains of dirt mixed with remnants of asphalt and debris used by the army to create inaccessible blockades, and creating tiny, somewhat safe passages for pedestrians on the remains of what had once been our road.
And so it went for the remainder of the period. During times of relative quiet, the road would be opened to pedestrians only, and remarkably, students, staff and faculty would brave the crossing, despite the danger of being stopped, detained, exposed to tear gas, shot at, humiliated and delayed. Through rubble, ditches and debris, they walked and climbed on slippery and dangerous paths. At times, it felt as though the entire nation, in defiance and in an incessant attempt to non-violently resist this inhuman onslaught, was walking these dangerous tracks to reach their destination.The walking distance varied in relation to new ditches that had been gouged out the night before. It stretched between the mountains of rubble and the ditches, as no car could pass these artificial obstacles. Gradually, the walking distance grew to a 1-2 kilometers uphill walk either to Birzeit or to Ramallah. Of course, children, the disabled and the elderly again suffered most, and gradually, we began to no longer see them at the crossing, instead see only the young and the fit.